Medical Care Coordinator
Medical Care Coordinator
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Salary Not Disclosed
1 Vacancy
Job Description
East or Southwest region of Michigan
Job Summary
A healthcare professional with a customer centric focus to coordinate outreach to and respond to members regarding issues and questions related to medical conditions benefits and coverage criteria. 1) Navigate members through our complex systems by working across the health plan and care network to ensure members receive and understand their care options. 2) Guide members through Priority Health networks internal and external medical resources policies procedures etc. 3) Act proactively on members behalf with routine benefits gaps in care and prior authorization processes. 4.) Works directly with members with rising risk or identified with rising risk under supervision of a licensed Care Manager to provide delegated tasks for disease specific education for both adult and pediatric population and reinforcement of the treatment plan.
Essential Functions
- Candidates in this role should reside in the East or Southwest region of Michigan as HIDE will be implemented first in Barry Berrien Branch Calhoun Cass Kalamazoo St. Joseph Van Buren Macomb Oakland and Wayne counties which includes home visits in 2026.
- Navigate members through our complex systems by working across the health plan and care network to ensure members receive and understand their care options.
- Is the members first point of contact into Care Management. Assesses and identifies the needs and evaluates to determine if the member needs complex care management. If the needs are not complex assists the member to meet their health care needs.
- Guide members through Priority Health networks internal and external medical resources policies procedures etc.
- Acts proactively on members behalf with routine benefits gaps in care and prior authorization processes.
- Works directly with members with rising risk or identified with rising risk under supervision of a licensed Care Manager to provide delegated tasks for disease specific education for both adult and pediatric population and reinforcement of the treatment plan.
- Identifies barriers and social determinants of health and assists to address or eliminate these barriers.
- Manages a caseload up to 450 members with stable but complex conditions or rising risk related to chronic conditions.
Qualifications
- Michigan Licensed Bachelors prepared social worker or Limited License Masters prepared social worker or Limited License Bachelors prepared social worker.
- Skills/knowledge/abilities typically gained through less than 2 years of related work experience in a clinical office or health insurance setting.
- 3 years of relevant experience Working in an organization of size and complexity comparable to Corewell Health or managed care organization.
Preferred
- 5 years of relevant experience Related work in a clinical office or health insurance setting
About Corewell Health
As a team member at Corewell Health you will play an essential role in delivering personalized health care to our patients members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators leaders and innovators that continue to build on one shared mission statement - to improve health instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.
How Corewell Health cares for you
Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!
Optional identity theft protection home and auto insurance pet insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Beaumont Service Center - 26901 Beaumont BlvdDepartment Name
PH - Care Management - DSNPEmployment Type
Full timeShift
Day (United States of America)Weekly Scheduled Hours
40Hours of Work
8 a.m. to 5 p.m.Days Worked
Monday to FridayWeekend Frequency
N/ACURRENT COREWELL HEALTH TEAM MEMBERS Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.
An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
Required Experience:
IC
Employment Type
Full-Time
